Provider Demographics
NPI:1811133754
Name:NEW BERLIN FIRE COMPANY NUMBER ONE
Entity type:Organization
Organization Name:NEW BERLIN FIRE COMPANY NUMBER ONE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARTH
Authorized Official - Middle Name:R
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-966-2552
Mailing Address - Street 1:PO BOX 386
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:PA
Mailing Address - Zip Code:17855-0386
Mailing Address - Country:US
Mailing Address - Phone:570-966-2552
Mailing Address - Fax:
Practice Address - Street 1:415 HIGH ST
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:PA
Practice Address - Zip Code:17855-8058
Practice Address - Country:US
Practice Address - Phone:570-966-2552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-24
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023137500001Medicaid
P00806191Medicare PIN
PA1023137500001Medicaid